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Financing Global Health 2018: Past, present, and future of total and disease-specific health spending
Joseph Dieleman, PhDApril 25, 2019
Thank you
A huge thank you to:1. Kaiser Family Foundation and Center for Strategic and International
Studies
2. Bill and Melinda Gates Foundation
3. IHME team: Angela Chang, Krycia Cowling, Abby Chapin, Catherine Chen, Annie Haakenstad, Connor Harle, Gloria Ikilezi, Margot Kahn Case, Mark Moses, Nafis Sadat, Miranda Tao, Goli Tsakalos,Yingxi Zhao, Bianca Zlavog, Kat Beame, Kelly Bienhoff, Adrienne Chew, Selina Deiparine, Kris Krohn, Katie Leach-Kemon, Michaela Loeffler, Angela Micah, Kate Muller, Chris Murray, Molly Nixon, Dean Owen, Disha Patel, Anna Torre, Joan Williams, Junjie Wu, and Teddy Younker
4. Global Burden of Disease Health Financing Collaborator Network www.healthdata.org/gbd/call-for-collaborators
10 years of Financing Global Health reports
2009–2017 became a global authority on development assistance for health
2018 focuses on domestic health spending, DAH, HIV/AIDS, and malaria
Financing Global Health papers
1
Joseph L Dieleman, Angela E Micah, and Christopher JL Murray
2
Financing Global Health papers
3
4
Outline
I. Past, present, and future of total health spending
II. Development assistance for health
III. Disease specific health spending – HIV/AIDS and malaria
IV. Health spending and universal health coverage
Total health spending, 2016 - $8.0 trillionTHE pc map
8
Health spending per person
Total health spending, 2016 - $8.0 trillion
17%
35%
39%
10%
81%
16%
3%
0.4%
Global population Global health spending
How is health spending changing?
Gross domestic product per person
Health spending
per person
1995
How is health spending changing?
Gross domestic product per person
Health spending
per person
1995
2016
How is health spending changing?
Gross domestic product per person
Health spending
per person
1995
2016
2030
How is health spending changing?
Gross domestic product per person
Health spending
per person
1995
2016
2030
2050
How is health spending changing?
14
Health spending
per person
Health spending per
person in high-income
countries
Health spending per
person in low-income
countries
Development assistance for health - $38.9 billion
15
DAH bar chartBillions of 2018
US dollars
Development assistance for health - $38.9 billion
16
DAH bar chartBillions of 2018
US dollars 4.9% annual growth
11.8% annual growth
0.6% annual growth
Development assistance for health - $38.9 billion
17
DAH bar chartBillions of 2018
US dollars
China -$645m
US -$13.2b
Development assistance for health - $38.9 billion
DAH stacked bar by HFA
Billio
ns o
f 201
8 U
S do
llars
2018 2011-2018growth rate
SWAP / HSS
$5.6b -0.7%
Maternal $4.7b 1.9%
Child $7.8b 6.2%
Malaria $2.1b -0.4%
TB $1.6b 2.2%
HIV $9.5b -3.0%
HIV/AIDS and malaria spending
Development assistance
Government spending
Out-of-pocket
Development assistance
Government spending
Global project and admin Global project
and admin
Malaria spending (106 endemic countries)HIV/AIDS spending (low- and middle-income countries)
HIV/AIDS spending - $19.9b in low- and middle-income1. Treatment and prevention by financing source
20
Billions of 2018 US dollars
Domestic funding
Donor funding
21
HIV/AIDS spending - $19.9b in low- and middle-income 2. Percent of HIV/AIDS spending from DAH, 2016
HIV/AIDS spending –
3. Measuring the potential for additional government, 2016
22
Malaria spending –1. Malaria spending by elimination status, 2016
23
Billions of 2018 US dollars
Malaria spending –2. Malaria spending by source and incidence, 2016
Government spending
Development assistance for malaria
OOP
Modeled fraction of total malaria
spending
(Elimination countries) (Controlling countries)
What does this mean for universal health coverage?
Health spending
per person
Health spending per
person in high-income
countries
Health spending per
person in low-income
countries
What does this mean for universal health coverage?100%
75%
50%
25%
Percent of health spending that is
domestic, prepaid
3.2 billion people live in countries with OOP and DAH making up > 50% of health spending
Thank you
dieleman@uw.edu
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